eyesmart.com.au

“The Macular Degeneration Foundation (MDF) is relieved that the Federal Government’s budget announcement to introduce a cap on the Medicare item number for the treatment of wet Age-related Macular Degeneration (AMD), the leading cause of blindness in Australia should have minimal impact on patients, said MDF CEO, Julie Heraghty.

From 1 November 2012 intravitreal injections will have an Extended Medicare Safety Net (EMSN) cap equal to 80 per cent of the Medicare Benefits Schedule (MBS) or $236.12 (based on current fees). This will mean that for the vast majority of patients there will be no change to their out of pocket costs.

No patient who is charged less than $546 for their injection will be worse off. 90 per cent of providers have average fees below the minimum fee for the patient to be affected ($546) and it is estimated that 85 per cent of current out of hospital services will not be affected by the cap. “The cap has been set at a constructive and workable level so as not to impact on access to affordable treatment for most patients. Without treatment, wet AMD patients will typically lose significant sight within months. Almost 30% will be legally blind within 12 months, and 40% by 24 months,” said Heraghty.

Under the changes, for a small number of patients where the doctor is charging more than $546, there will be additional out of pocket expenses. Julie Heraghty said, “The MDF is committed to monitoring high fee treatment areas very closely to ensure patients impacted by this cap are able to access sight saving treatment”. In 2009 the Macular Degeneration Foundation fought hard to ensure patients were not impacted by an unrealistic cap and fortunately in 2012 the Government has taken our messages on board and have set a cap that is workable.

Capping of Item 42740 (used for the injection into the eye of the treatment for wet AMD) was undertaken in the Federal Budget May 2009. This was rejected in the Senate and subsequently the decision was reversed by the Government in September 2009. 

Optometrists from Flinders University will soon be able to diagnose and manage eye diseases in rural and remote communities – all from the comfort of their computer chair.

Under the plan, people with a suspected diabetes-related eye problem can visit a partnering health care clinic in remote regions of the state where a special retinal camera takes a picture of the back of the eye, sending the digital images electronically to Flinders optometrists for assessment.

Indigenous Australians are particularly susceptible to diabetes-related eye disease, a common complication of diabetes that affects the small blood vessels in the back of the retina and causes them to leak, break down or become blocked, impairing vision.

Professor Konrad Pesudovs, Head of Optometry and Vision Science at Flinders, said the project would be based on a similar model of “telemedicine” used by the world’s best optometry school – the University of California, Berkeley.

Since launching in 2005, the Berkeley program has grown from just a few hundred eye examinations a month to more than 30,000 a year throughout California’s Central Valley.

Professor Pesudovs met with his Californian counterpart, Professor Tony Adams, in April to discuss the program and future plans for the expansion of Optometry and Vision Science at Flinders.

“We’ve been doing it at Berkeley for a few years now and we’re quite excited that Flinders is also interested in running this kind of model of care, especially in remote areas,” Dr Adams, an Emeritus Professor of Optometry and Vision Science at the University of California, said. “A whole bunch of people with diabetes in Alice Springs, for example, could get tested in their own town and the trained clinicians in a big city such as Adelaide can give feedback, almost instantly, on how to treat these patients,” he said. “And from what I’ve heard about the needs in remote parts of South Australia I can’t think of a better place to bring this in.”

Professor Pesudovs said the project was now being trialled in partnership with an Aboriginal health centre in Port Pirie, with plans in place to create a wider network of clinics linked to a central Flinders “telemedicine eye centre”. “We’re hoping the program will reach people who don’t have access to an ophthalmologist or an optometrist and we also see it as a great benefit to our students because they will be able to diagnose and manage treatment plans firsthand,” Professor Pesudovs said.

As part of his Australian visit, Professor Adams toured Flinders optometry school, describing its close proximity to the medical centre as a great benefit for students, staff and patients.

“Having a hospital, medical school and a university all on the same site is not very typical but it gets you immersed in patient care and issues much quicker,” he said. “I’ve also had a chance to hear about some of the future developments for the discipline and I think they’re quite innovative and exciting.”

Born in Melbourne, Professor Adams studied optometry at Melbourne University before moving to the US to complete his PhD at the University of Indiana. In 1968 he moved to Berkeley where he managed the PhD program for several years and spent a decade in the 1990s as Dean of the School of Optometry and Vision Science.

The Royal Victorian Eye and Ear Hospital joins the Bionic Vision Australia (BVA) consortium as a supporting participant and clinical partner of the bionic eye project. The partnership agreement marks a significant milestone as researchers, surgeons and clinicians work towards testing the bionic eye with patients at the Eye and Ear Hospital.

The Royal Victorian Eye and Ear Hospital is home to the Centre for Eye Research Australia, also part of the bionic eye consortium. Over the last few years, CERA's clinicians and surgeons have been screening patients to learn more about the structure and function of the eye under retinal degeneration and to develop safe surgical techniques for inserting the retinal implant.

Bionic Vision Australia brings together a wide range of experts, from vision scientists, ophthalmologists and retinal surgeons to neuroscientists, materials scientists, biomedical and electrical engineers. The goal of the project is to develop a retinal implant, or bioninc eye, capable of restoring a sense of vision to people with profound blindness due to retinitis pigmentosa and age-related macular degeneration.

Early April the consortium unveiled the microchip that is expected to power Australia's first bionic eye. Associate Professor Gregg Suaning, of the Graduate School of Biomedical Engineering and a project leader in the national bionic eye consortium, Bionic Vision Australia, said the new, 98-channel microchip, now undergoing preliminary lab testing, was a major step towards the goal of a functional bionic eye.

BVA Director, Professor Anthony Burkitt, said the production of the chip, a year after BVA received funding for the bionic eye project, represented "a major advance in technology". The microchip is performing well in preliminary lab testing. It will be at the core of the Wide-View neurostimulator device being developed by BVA, with the first full implant of the system in a patient planned for 2013.